1. Field of the Invention
The invention relates to methods and devices for the fixation of small bone fractures, and more particularly to methods and devices for the fixation of fractures of the phalangeal, metacarpal, and metatarsal bones.
2. Description of the Related Art
Bones which have been fractured should be immobilized on either side of the fracture for proper healing. Fractures of the phalanges and metacarpals of the hand, and the phalanges and metatarsals of the foot are quite common. Various techniques and fixation devices have been used to maintain proper fracture reduction in the phalangeal, metacarpal, and metatarsal bones.
One fixation method for phalangeal, metacarpal, and metatarsal bones uses plates and screws attached to the bone. A problem with this fixation method for displaced phalanx fractures, metacarpal fractures, and metatarsal fractures is that it requires open reduction with plate and screws which can be quite damaging to the soft tissues and extensor mechanism, limiting the postoperative outcome secondary to the soft tissue scarring.
Another fracture fixation method for phalangeal, metacarpal, and metatarsal bones relies upon the use of Kirschner wires (K-wires) to stabilize the bone at the line of fracture. K-wires are usually left proud above the bone and do not have a fixation point per se. K-wires are left proud so that they can be removed at a later date. These K-wires that are left proud can become infected as well as irritate soft tissue. Because of their lack of point fixation, they can also end up migrating or loosening. This results then in potential loss of the fixation with either malunion or nonunion.
Other methods and devices for the fixation of a fractured metacarpal, metatarsal, or phalangeal bone are described in U.S. Pat. Nos. 6,200,321, 6,273,892 and 6,533,788. This fracture fixation system uses an instrument that includes a main handle and a pin handle movable relative to the main handle. The main handle includes a distal end with a drill, and a longitudinal slot which receives the pin handle. In use, the main handle of the instrument is manipulated to subcutaneously introduce the drill into the metacarpal, metatarsal, or phalangeal bone, and the pin handle is then moved relative to the main handle to introduce a pin into the bone until it extends through the medullary canal on either side of the fracture.
However, there still exists a need for improved methods and devices for the fixation of fractures of the phalangeal, metacarpal, and metatarsal bones wherein the methods and devices can maintain proper fracture reduction with minimal trauma to surrounding tissue.